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A Controlled Study of Cognitive Behaviour Therapy with Buspirone or Placebo in Panic Disorder with Agoraphobia

Published online by Cambridge University Press:  02 January 2018

Jean Cottraux*
Affiliation:
Anxiety Disorder Unit, Hôpital Neurologique, Lyon
Ivan-Druon Note
Affiliation:
Behaviour Therapy Unit, Hôpital Sainte Marguerite, Marseille
Charly Cungi
Affiliation:
10 avenue Gantin, 74150 Rumilly
Patrick Légeron
Affiliation:
Centre Hospitalier, Villeneuve Saint Georges
François Heim
Affiliation:
Centre Médical de la Reynerie, Toulouse
Laurent Chneiweiss
Affiliation:
35 avenue de la Motte Picquet 75007, Paris
Geneviève Bernard
Affiliation:
Anxiety Disorder Unit, Hôpital Neurologique, Lyon, France
Martine Bouvard
Affiliation:
Anxiety Disorder Unit, Hôpital Neurologique, Lyon, France
*
Dr Cottraux, Anxiety Disorder Unit, Hôpital Neurologique, 59 Boulevard Pinel, 69394 Lyon, France

Abstract

Background

This multicentre study compared a 16-week buspirone treatment with placebo in patients presenting with panic disorder with agoraphobia and also receiving cognitive behaviour therapy (CBT).

Method

Double-blind testing was maintained until week 68, but not tested; 91 patients were included; 14 placebo-responders excluded; 77 patients randomised; 48 reached week 16 and 41 reached week 68.

Results

At week 16, within-group analysis showed significant improvements in agoraphobia, panic attacks, and depression in both groups. Generalised anxiety improved only in CBT + buspirone. Between-group comparisons showed buspirone to have an effect on generalised anxiety and agoraphobia. Changes in degree of agoraphobia and depression were correlated in subjects on CBT + buspirone only. A significantly higher proportion of women, and of subjects showing high avoidance dropped out. Positive expectations regarding medication predicted success in both groups. At week 68, improvement was retained without significant buspirone effect.

Conclusion

Buspirone enhanced the effects of cognitive behaviour therapy on generalised anxiety and agoraphobia in the short term.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders, (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Barlow, D. H. & Cerny, J. A. (1988) Psychological Treatment of Panic. New York: The Guilford Press.Google Scholar
Barlow, D. H., Craske, M., Cerny, J. A., et al (1989) Behavioral treatment of panic disorder. Behavior Therapy, 20, 261282.CrossRefGoogle Scholar
Beck, A. T., Emery, G. & Greenberg, R. L. (1985) Anxiety Disorders and Phobias: A Cognitive Perspective. New York: Basic Books.Google Scholar
Chambless, D., Caputo, G., Bright, P., et al (1984) Assessment of fear in agoraphobics: the body sensation questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 10901097.CrossRefGoogle ScholarPubMed
Clark, D., Salkovskis, P., Hackmann, A., et al (1994) Comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder. British Journal of Psychiatry, 164, 759769.CrossRefGoogle ScholarPubMed
Clum, G. A. (1989) Psychological interventions vs drugs in the treatment of panic. Behavior Therapy, 20, 429457.CrossRefGoogle Scholar
Cottraux, J. (1993) Behavior Therapy. In Treatment of Mental Disorders. A Review of Effectiveness (eds Sartorius, N., De Girolamo, G., Andrews, G., et al), pp. 199232. Geneva: WHO.Google Scholar
Guelfi, J. D. (1993) L'évaluation Clinique en Psychiatrie. Castres: Pierre Fabre.Google Scholar
Hogduin, C. A. L., De Haan, E. & Schaap, C. (1989) The significance of patient-therapist relationship in the treatment of obsessive–compulsive disorder. British Journal of Clinical Psychology, 28, 185186.CrossRefGoogle Scholar
Margraf, J., Barlow, D. H., Clark, D. M., et al (1993) Psychological treatment of panic: work in progress on outcome, active ingredients and follow-up. Behaviour Research and Therapy, 31, 18.CrossRefGoogle ScholarPubMed
Marks, I. M., Hallam, R., Connoly, J., et al (1977) Nursing in Behavioural Psychotherapy. An Advanced Clinical Role for Nurses. London: Whitefriars.Google Scholar
Marks, I. M., Swinson, R., Basoglu, M., et al (1993) Alprazolam and exposure alone or combined in panic disorder with agoraphobia: a controlled study in London and Toronto. British Journal of Psychiatry, 162, 776787.CrossRefGoogle ScholarPubMed
Mavissakalian, M. & Perel, J. (1992) Clinical experiments in maintenance and discontinuation of imipramine therapy in panic disorder with agoraphobia. Archives of General Psychiatry, 49, 318323.Google Scholar
Munjack, D. J., Bruns, J., Balthazar, P. L., et al (1991) Pilot study of buspirone in the treatment of social phobia. Journal of Anxiety Disorders, 5, 8798.CrossRefGoogle Scholar
Rickels, K., Amsterdam, J. D., Clary, C., et al (1991) Buspirone in major depression: a controlled study. Journal of Clinical Psychiatry, 52, 3438.Google ScholarPubMed
Sheehan, D. V., Ashok, B., Sheehan, H., et al (1990) Is buspirone effective in panic disorder? Journal of Clinical Psychopharmacology, 10, 311.CrossRefGoogle ScholarPubMed
Wardle, J., Hayward, P., Higgitt, A., et al (1994) Effects of concurrent diazepam treatment on the outcome of exposure therapy in agoraphobia. Behaviour Research and Therapy, 32, 203215.CrossRefGoogle ScholarPubMed
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